American journal of respiratory and critical care medicine最新文献

{"title":"Pinocchio and Interstitial Lung Abnormalities: Is It Just Another Lie?","authors":"Sara Tomassetti, Claudia Ravaglia, Venerino Poletti","doi":"10.1164/rccm.202309-1683LE","DOIUrl":"10.1164/rccm.202309-1683LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1341-1342"},"PeriodicalIF":19.3,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minocycline-induced Acute Fibrinous and Organizing Pneumonia.","authors":"Toshiyuki Sumi, Kotomi Terai, Keito Suzuki, Yuta Koshino, Takumi Ikeda, Hiroki Watanabe, Yuichi Yamada, Hirofumi Chiba","doi":"10.1164/rccm.202305-0885IM","DOIUrl":"10.1164/rccm.202305-0885IM","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"e47-e48"},"PeriodicalIF":19.3,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Video-assisted Thoracoscopic Surgery or Intrapleural Enzyme Therapy in Pleural Infection: A Feasibility Randomized Controlled Trial. The Third Multicenter Intrapleural Sepsis Trial-MIST-3.","authors":"Eihab O Bedawi, Dionisios Stavroulias, Emma Hedley, Kevin G Blyth, Alan Kirk, Duneesha De Fonseka, John G Edwards, Eveline Internullo, John P Corcoran, Adrian Marchbank, Rakesh Panchal, Edward Caruana, Owais Kadwani, Lawrence Okiror, Tarek Saba, Manoj Purohit, Rachel M Mercer, Rhona Taberham, Nikolaos Kanellakis, Alison M Condliffe, Leon G Lewis, Dinesh N Addala, Rachelle Asciak, Radhika Banka, Vineeth George, Maged Hassan, David McCracken, Anand Sundaralingam, John M Wrightson, Melissa Dobson, Alex West, Graham Barnes, John Harvey, Mark Slade, Mae Chester-Jones, Susan Dutton, Robert F Miller, Nick A Maskell, Elizabeth Belcher, Najib M Rahman","doi":"10.1164/rccm.202305-0854OC","DOIUrl":"10.1164/rccm.202305-0854OC","url":null,"abstract":"<p><p><b>Rationale:</b> Assessing the early use of video-assisted thoracoscopic surgery (VATS) or intrapleural enzyme therapy (IET) in pleural infection requires a phase III randomized controlled trial (RCT). <b>Objectives:</b> To establish the feasibility of randomization in a surgery-versus-nonsurgery trial as well as the key outcome measures that are important to identify relevant patient-centered outcomes in a subsequent RCT. <b>Methods:</b> The MIST-3 (third Multicenter Intrapleural Sepsis Trial) was a prospective multicenter RCT involving eight U.K. centers combining on-site and off-site surgical services. The study enrolled all patients with a confirmed diagnosis of pleural infection and randomized those with ongoing pleural sepsis after an initial period (as long as 24 h) of standard care to one of three treatment arms: continued standard care, early IET, or a surgical opinion with regard to early VATS. The primary outcome was feasibility based on >50% of eligible patients being successfully randomized, >95% of randomized participants retained to discharge, and >80% of randomized participants retained to 2 weeks of follow-up. The analysis was performed per intention to treat. <b>Measurements and Main Results:</b> Of 97 eligible patients, 60 (62%) were randomized, with 100% retained to discharge and 84% retained to 2 weeks. Baseline demographic, clinical, and microbiological characteristics of the patients were similar across groups. Median times to intervention were 1.0 and 3.5 days in the IET and surgery groups, respectively (<i>P</i> = 0.02). Despite the difference in time to intervention, length of stay (from randomization to discharge) was similar in both intervention arms (7 d) compared with standard care (10 d) (<i>P</i> = 0.70). There were no significant intergroup differences in 2-month readmission and further intervention, although the study was not adequately powered for this outcome. Compared with VATS, IET demonstrated a larger improvement in mean EuroQol five-dimension health utility index (five-level edition) from baseline (0.35) to 2 months (0.83) (<i>P</i> = 0.023). One serious adverse event was reported in the VATS arm. <b>Conclusions:</b> This is the first multicenter RCT of early IET versus early surgery in pleural infection. Despite the logistical challenges posed by the coronavirus disease (COVID-19) pandemic, the study met its predefined feasibility criteria, demonstrated potential shortening of length of stay with early surgery, and signals toward earlier resolution of pain and a shortened recovery with IET. The study findings suggest that a definitive phase III study is feasible but highlights important considerations and significant modifications to the design that would be required to adequately assess optimal initial management in pleural infection.The trial was registered on ISRCTN (number 18,192,121).</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1305-1315"},"PeriodicalIF":19.3,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41188492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Noninvasive Ventilation on Postextubation Brain-Injured Patients: Looking for Evidence?","authors":"Dipasri Bhattacharya, Antonio M Esquinas, Mohanchandra Mandal","doi":"10.1164/rccm.202308-1442LE","DOIUrl":"10.1164/rccm.202308-1442LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1244-1245"},"PeriodicalIF":24.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Li <i>et al</i>.","authors":"Lei Wang, Yang Cai, Johan Garssen, Paul A J Henricks, Gert Folkerts, Saskia Braber","doi":"10.1164/rccm.202308-1418LE","DOIUrl":"10.1164/rccm.202308-1418LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1240-1241"},"PeriodicalIF":24.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10523476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatic Mutations: The Next Frontier in Demystifying Chronic Obstructive Pulmonary Disease and Idiopathic Pulmonary Fibrosis?","authors":"Xiting Yan, Naftali Kaminski","doi":"10.1164/rccm.202310-1774ED","DOIUrl":"10.1164/rccm.202310-1774ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1150-1151"},"PeriodicalIF":24.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49673345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Rehabilitation for Post-Tuberculosis Lung Disease.","authors":"Ifeanyichukwu U Anidi, Bruce Kirenga, Kevin P Fennelly","doi":"10.1164/rccm.202309-1571LE","DOIUrl":"10.1164/rccm.202309-1571LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1246-1247"},"PeriodicalIF":24.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tacrolimus and the Treatment of Pulmonary Fibrosis.","authors":"Deying Huang, Yanhong Li, Yi Liu","doi":"10.1164/rccm.202308-1445LE","DOIUrl":"10.1164/rccm.202308-1445LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1241-1242"},"PeriodicalIF":24.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Endotyping in Bronchiectasis.","authors":"Pamela J McShane","doi":"10.1164/rccm.202310-1827ED","DOIUrl":"10.1164/rccm.202310-1827ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1147-1148"},"PeriodicalIF":24.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilatory Burden as a Measure of Obstructive Sleep Apnea Severity Is Predictive of Cardiovascular and All-Cause Mortality.","authors":"Ankit Parekh, Korey Kam, Sajila Wickramaratne, Thomas M Tolbert, Andrew Varga, Ricardo Osorio, Monica Andersen, Luciana B M de Godoy, Luciana O Palombini, Sergio Tufik, Indu Ayappa, David M Rapoport","doi":"10.1164/rccm.202301-0109OC","DOIUrl":"10.1164/rccm.202301-0109OC","url":null,"abstract":"<p><p><b>Rationale:</b> The apnea-hypopnea index (AHI), used for the diagnosis of obstructive sleep apnea, captures only the frequency of respiratory events and has demonstrable limitations. <b>Objectives:</b> We propose a novel automated measure, termed \"ventilatory burden\" (VB), that represents the proportion of overnight breaths with less than 50% normalized amplitude, and we show its ability to overcome limitations of AHI. <b>Methods:</b> Data from two epidemiological cohorts (EPISONO [Sao Paolo Epidemiological Study] and SHHS [Sleep Heart Health Study]) and two retrospective clinical cohorts (DAYFUN; New York University Center for Brain Health) were used in this study to <i>1</i>) derive the normative range of VB, <i>2</i>) assess the relationship between degree of upper airway obstruction and VB, and <i>3</i>) assess the relationship between VB and all-cause and cardiovascular disease (CVD) mortality with and without hypoxic burden that was derived using an in-house automated algorithm. <b>Measurements and Main Results:</b> The 95th percentiles of VB in asymptomatic healthy subjects across the EPISONO and the DAYFUN cohorts were 25.2% and 26.7%, respectively (median [interquartile range], VB_EPISONO, 5.5 [3.5-9.7]%; VB_DAYFUN, 9.8 [6.4-15.6]%). VB was associated with the degree of upper airway obstruction in a dose-response manner (VB_untreated, 31.6 [27.1]%; VB_treated, 7.2 [4.7]%; VB_{suboptimally treated}, 17.6 [18.7]%; VB_{off-treatment}, 41.6 [18.1]%) and exhibited low night-to-night variability (intraclass correlation coefficient [2,1], 0.89). VB was predictive of all-cause and CVD mortality in the SHHS cohort before and after adjusting for covariates including hypoxic burden. Although AHI was predictive of all-cause mortality, it was not associated with CVD mortality in the SHHS cohort. <b>Conclusions:</b> Automated VB can effectively assess obstructive sleep apnea severity, is predictive of all-cause and CVD mortality, and may be a viable alternative to the AHI.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1216-1226"},"PeriodicalIF":19.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10284626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}